Comparison of five portable peak flow meters

OBJECTIVE: To compare the measurements of spirometric peak expiratory flow (PEF) from five different PEF meters and to determine if their values are in agreement. Inaccurate equipment may result in incorrect diagnoses of asthma and inappropriate treatments. METHODS: Sixty-eight healthy, sedentary and insufficiently active subjects, aged from 19 to 40 years, performed PEF measurements using Air Zone®, Assess®, Galemed®, Personal Best® and Vitalograph® peak flow meters. The highest value recorded for each subject for each device was compared to the corresponding spirometric values using Friedman's test with Dunn's post-hoc (p<0.05), Spearman's correlation test and Bland-Altman's agreement test. RESULTS: The median and interquartile ranges for the spirometric values and the Air Zone®, Assess®, Galemed®, Personal Best® and Vitalograph® meters were 428 (263-688 L/min), 450 (350-800 L/min), 420 (310-720 L/min), 380 (300-735 L/min), 400 (310-685 L/min) and 415 (335-610 L/min), respectively. Significant differences were found when the spirometric values were compared to those recorded by the Air Zone® (p<0.001) and Galemed ® (p<0.01) meters. There was no agreement between the spirometric values and the five PEF meters. CONCLUSIONS: The results suggest that the values recorded from Galemed® meters may underestimate the actual value, which could lead to unnecessary interventions, and that Air Zone® meters overestimate spirometric values, which could obfuscate the need for intervention. These findings must be taken into account when interpreting both devices' results in younger people. These differences should also be considered when directly comparing values from different types of PEF meters

Relationship of Bode Index to Functional Tests in Chronic Obstructive Pulmonary Disease

OBJECTIVE: To determine if there is a correlation between the BODE Index and variables assessed during the Activities of Daily Living assessment, performance on lower limber tests, and peripheral muscle impairment of the upper limb in patients with chronic obstructive pulmonary disease. MATERIALS AND METHODS: Ten men (aged 58 to 80 years old) with moderate to very severe obstruction were evaluated and classified by the BODE Index. They were evaluated by pulmonary ventilation (V•E), oxygen consumption (V•O2), and carbonic gas production (V•CO2) on the ADL assessment; Distance Walking (DW) in the Six Minute Walking Test (6MWT) and the Six Minute Walking Test on Treadmill (6MWTT); number of repetitions in the Sit-to-Stand Test; and the Hand Grip Strength Test. Correlations were evaluated between the classification and the tests performed (Pearson and Spearman test, p<0.05). RESULTS: The mean of the total score for the BODE Index was 2.80 (±1.03), with three patients scoring in the first quartile (Q1) and seven scoring in the second quartile (Q2). This Index showed a negative correlation with the 6MWTT (r=-0.86), the Sit-to-Stand Test (r=-0.66), and the Hand Grip Strength Test (r=-0.83). CONCLUSIONS: Our results show that there is no correlation between the BODE Index and the ventilatory and metabolic responses in the Activities of Daily Living assessment. On the other hand, a correlation was observed between the BODE Index and the variables assessed in the 6MWTT, Sit-to-Stand Test, and Hand Grip Strength Test in moderate to very severe Chronic Obstructive Pulmonary Disease patients. This suggests that these tests can be employed as predictors of physical exercise capacity, perhaps as complementary tests to the BODE Index

Internações hospitalares, óbitos, custos com doenças respiratórias e sua relação com alterações climáticas no município de São Carlos - SP, Brasil

Study design: Ecological time-series study Objectives: To describe respiratory disease (RD) hospitalizations, deaths, costs and verify their relations with climate change. Methods: Annual and monthly data were collected from hospital admission record (HAR) and deaths of the Department of the Unified Health System provided by the system of the SUS Hospital Information, in the period 2008 to 2012, which included the number of HAR, deaths and costs with RD, according to International Classification of Diseases, in São Carlos/SP, Brazil. In addition, we collected meteorological data (average maximum temperature, average minimum temperature and humidity relative air) through the National Institute of Meteorology (INMET) in the same period. Results: A total of 7.144 RD hospitalizations were authorized, and pneumonia was the most prevalent (59.93%). There was a decrease of HAR and public costs and increased total mortality rate RD (10.8%) from 2008 to 2012. The HAR had moderate (0.50- 0.69) and negative correlation with the average temperature compensated and maximum; and weak negative correlation with average temperature minimum. Mortality rate had a positive weak correlation (0.26-0.49) with average temperature compensated and maximum temperature. Costs had a negative weak correlation with average temperature compensated, maximum and minimum. Conclusion: RD responsible for the largest HAR values and deaths were pneumonia, COPD, acute bronchitis, acute bronchiolitis, asthma and chronic diseases of tonsils and adenoids. It was also observed that climate change were associated with HAR, mortality rate and health costsModelo do estudo: Estudo ecológico de séries temporais. Objetivos: Descrever as internações hospitalares, óbitos e custos com as doenças respiratórias (DR) e verificar suas relações com as alterações climáticas. Métodos: Dados anuais e mensais foram coletados do registro de autorização de internação hospitalar (AIH) e óbitos do Departamento de Informática do Sistema Único de Saúde, fornecidos pelo Sistema de Informações Hospitalares do SUS, no período de 2008 a 2012, que incluíram o número de AIH, óbitos e custos com DR, segundo Código Internacional de Doenças, no município de São Carlos - SP, Brasil. Ainda, coletaram-se dados meteorológicos (temperaturas médias compensada, máxima e mínima e umidade relativa do ar) por meio do Instituto Nacional de Meteorologia (INMET) no mesmo período. Resultados: Totalizaram-se 7.144 internações hospitalares por DR autorizadas, sendo a pneumonia a mais prevalente (59,93%). Observou-se decréscimo das AIH e dos custos públicos e aumento da taxa de mortalidade total por DR (10,8%) de 2008 para 2012. As AIH apresentaram correlação moderada (0,50-0,69) e negativa com as temperaturas médias compensada e máxima; e correlação fraca (0,26-0,49) e negativa com a temperatura média mínima. Já a taxa de mortalidade correlacionouse fraca e positivamente com a temperatura média compensada e a temperatura máxima. Os custos correlacionaram-se fraca e negativamente com as temperaturas médias compensada, máxima e mínima. Conclusão: As DR responsáveis pelos maiores valores de AIH e óbitos foram a pneumonia, DPOC, bronquite aguda, bronquiolite aguda, asma e doenças crônicas das amígdalas e adenoide. Observou-se ainda que as alterações climáticas apresentaram relação com a AIH, taxa de mortalidade e custos com saúd

Chronic obstructive pulmonary disease Assessment Test in assessing of patients with chronic obstructive pulmonary disease: there is a relationship with activities of daily living and mortality predictor index? A cross-sectional study

The aim of this study was to investigate if there is a relationship between the impact of Chronic Obstructive Pulmonary Disease (COPD) on health status and the level of dyspnea in Activities of Daily Living (ADL) and the mortality predictor index in patients undergoing Pulmonary Rehabilitation (PR). It is a cross-sectional study in which 32 patients with moderate to very severe COPD (23 men; 66.6±12.0 years; FEV1: 40.6±15.6% predicted) were assessed by: COPD Assessment Test (CAT), Body Mass Index (BMI), six-Minute Walking Test (6MWT), London Chest Activity of Daily Living Scale (LCADL), modified Medical Research Council (mMRC) and BODE Index (Body mass index, airflow Obstruction, Dyspnea and Exercise capacity). The CAT score presented moderate correlation with the mMRC questionnaire (r=0.35; p=0.048), total score of LCADL (r=0.60; pO objetivo do estudo foi investigar se há relação entre o impacto da Doença Pulmonar Obstrutiva Crônica (DPOC) no estado de saúde com o nível de dispneia nas atividades de vida diária (AVD) e o índice preditor de mortalidade em pacientes em reabilitação pulmonar (RP). Trata-se de um estudo transversal, em que foram avaliados 32 pacientes com DPOC moderada a muito grave (23 homens; 66,6±12,0 anos; VEF1: 40,6±15,6% previsto) por meio do COPD Assessment Test (CAT), Índice de Massa Corpórea (IMC), Teste de Caminhada de Seis Minutos (TC6), London Chest Activity of Daily Living Scale (LCADL), modified Medical Research Council (mMRC) e Índice BODE (Body mass index, airflow Obstruction, Dyspnea and Exercise capacity). Observaram-se correlações positivas moderadas do CAT com o questionário mMRC (r=0,35; p=0,048), a pontuação total da LCADL (r=0,60; pEl objetivo del estudio fue investigar si hay relación entre el impacto de la Enfermedad Pulmonar Obstructiva Crónica (EPOC) en el estado de salud con el nivel de disnea en las actividades de la vida diaria (AVD) y el índice predictor de mortalidad en pacientes en rehabilitación pulmonar (RP). Se trata de un estudio transversal, en el que fueron evaluados 32 pacientes con EPOC moderada a muy grave (23 hombres; 66,6±12,0 años; VEF1: 40,6±15,6% previsto) por medio del COPD Assessment Test (CAT), Índice de Masa Corpórea (IMC), Test de Caminata de Seis Minutos (TC6), London Chest Activity of Daily Living Scale (LCADL), mo dified Medical Research Council (mMRC) e Índice BODE (Body mass index, airflow Obstruction, Dyspnea and Exercise capacity). Se observaron correlaciones positivas moderadas del CAT con el cuestionario mMRC (r=0,35; p=0,048), la puntuación total de la LCADL (r=0,60;

Aplicabilidade das equações de referência para o teste de caminhada de seis minutos em adultos e idosos saudáveis de um município do estado de São Paulo

O teste de caminhada de seis minutos (TC6) tem sido considerado simples, seguro, de fácil administração, além de fornecer resultados representativos sobre atividades habituais do dia a dia. Os objetivos do estudo foram avaliar e comparar a distância percorrida no TC6 com as distâncias previstas por equações disponíveis na literatura científica em adultos e idosos saudáveis do município de São Carlos (SP), e verificar a aplicabilidade dessas equações nessa população. Foram avaliados 43 indivíduos (23 homens), dos 55 aos 78 anos, por meio da avaliação física, espirometria e do TC6. Observamos que a distância percorrida no TC6 foi significativamente (teste t-pareado: pThe six-minute walk test (6MWT) has been considered simple, safe, easy administration, and provide representative results about normal activities of day-to-day. The objective of the study was to evaluate and compare the 6-min walk distance (6MWD) with predicted distance by reference equations available in the scientific literature in healthy elderly adults, and to verify the applicability of these reference equations in this population. Forty-three elderly adults apparently healthy (23 males) between 55 to 78 years old were assessed by means of general physical assessment, the spirometry and 6MWT. The 6MWT was performed twice, with 30-min interval between them. The 6MWD was significantly (paired t-test: pEl test de marcha de seis minutos (TM6) es considerado simple, seguro y de fácil administración, además de entregar resultados representativos sobre actividades habituales del día a día. Los objetivos del estudio fueron evaluar y comparar la distancia recorrida en el TM6 con las distancias previstas por ecuaciones disponibles en la literatura científica en adultos y adultos mayores saludables del municipio de Sao Carlos/SP, y verificar la aplicabilidad de esas ecuaciones en esta población. Fueron evaluados 43 individuos (23 hombres), entre los 55 a los 78 años, por medio de evaluación física, espirometría y del TM6. Observamos que la distancia recorrida en el TM6 fue significativamente (test t-pareado: